Journal of Rational-Emotive & Cognitive-Behavior Therapy

Volume 19, Number 3, Fall 2001

UNCONDITIONAL SELFACCEPTANCE AND

PSYCHOLOGICAL HEALTH
John M. Chamberlain
David A. F. Haaga
American University

ABSTRACT: Low self-esteem is usually considered unhealthy, but according

to rational-emotive behavior therapy, any level of self-esteem reflects a dysfunctional habit of globally evaluating ones worth; it would be preferable to
accept oneself unconditionally. This hypothesis was tested by examining several correlates of scores on a novel questionnaire measure of unconditional
self-acceptance (USA). In a nonclinical adult sample, statistically controlling
for self-esteem, USA was inversely correlated with anxiety symptoms and
with narcissism, positively correlated with state mood after imaginal exposure to negative events. Other predicted associations of USA (with depression, happiness, and self-deception) either were not evident or became nonsignificant when self-esteem was taken into account. Discussion centered on
the conceptual and operational distinctions between self-esteem and selfacceptance.
KEY WORDS: self-acceptance; self-esteem; psychological well-being.

Low self-esteem is typically considered dysfunctional. It is associated with, among other difficulties, experiencing depressive symptoms
(e.g., Beck, Steer, Epstein, & Brown, 1990; Tarlow & Haaga, 1996).
Such findings underlie the development of programs to enhance selfThis paper was based on the first authors doctoral dissertation at American University, chaired
by the second author. The research was supported by an internal grant from American University. We are grateful to dissertation committee members Tony Ahrens, Jim Gray, and Susan
Walen for their comments on earlier versions of this report.
Address correspondence, including requests for reprints, to David A. F. Haaga, Department of
Psychology, Asbury Building, American University, Washington, DC 20016-8062, USA; e-mail:
dhaagaamerican.edu.

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2001 Human Sciences Press, Inc.

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Journal of Rational-Emotive & Cognitive-Behavior Therapy

esteem (e.g., the California Task Force to Promote Self-esteem and

Personal and Social Responsibility; Mecca, Smelser, & Vasconcellos,
1989). Nevertheless, attempts to increase self-esteem may have drawbacks as well. Individuals with extremely high self-esteem, for instance, may be more prone to acts of violence (Baumeister, Smart, &
Boden, 1996). Those with high self-esteem may also be less open to
unfavorable feedback (Shrauger & Lund, 1975) and more emotionally
vulnerable to criticism (Schlenker, Soraci, & McCarthy, 1976).
Rational-emotive behavior therapy (REBT; Ellis, 1962, 1995) provides one possible explanation of the seeming paradox that either low
self-esteem or high self-esteem can be unhealthy. In particular, REBT
holds that the very presence of any level of self-esteem reflects occurrence of a dysfunctional self-rating process, an evaluation of ones
global worth as a person. REBT depicts self-rating as irrational inasmuch as there is no objective basis for determining the worth of a
human being. Self-ratings, then, have an intrinsic illegitimacy about
them, in that accurate or true self-ratings or global ratings seem virtually impossible to make (Ellis, 1976, p. 347).
Besides being illogical, self-rating is dysfunctional according to REBT,
predisposing people to feel depressed (if the rating is low) or anxious
(even if ones rating is currently high, the mindset of self-evaluation
foretells a fall in self-esteem in response to various failures, criticisms,
rejections, mistakes, or inabilities). Furthermore, self-rating (especially comparing of ones worth with others) tends to become a preoccupying pastime, distracting from the more rational goals of trying to
achieve happiness and to discover and pursue what one really wants
in life.
Elliss solution to the problem of self-rating is that people abandon
the quest for self-esteem and the self-rating process that accompanies
it and instead work toward unconditional self-acceptance (USA),
meaning that the individual fully and unconditionally accepts himself
whether or not he behaves intelligently, correctly, or competently and
whether or not other people approve, respect, or love him (Ellis, 1977,
p. 101). The hypothesis that USA is associated with mental health has
been part of REBT theory for decades, and related (though not identical) views have long been espoused by, among others, Carl Rogers
(1951), yet this idea has rarely been tested. Many outcome studies of
the efficacy of REBT as a treatment have been conducted (Engels, Garnefski, & Diekstra, 1993), but they have not tested whether increased
self-acceptance mediates any favorable impact of REBT (Haaga &
Davison, 1989).

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165

In the study reported in this article we developed a measure of USA

and recruited a nonclinical adult sample to evaluate in multiple ways
the REBT hypothesis that USA reflects a mentally healthy philosophy.
Several predictions were explored via cross-sectional correlation of
USA with other psychological variables. First, we expected USA to correlate negatively with depressive symptoms. REBT sees depression as
a natural consequence of self-rating, given that self-rating fosters low
self-rating and feelings of inadequacy in response to failure and rejection (Ellis, 1973). Second, USA should correlate negatively with anxiety because the self-rating process contributes to worry about losing
ones perceived level of self-worth even if one is currently having success and receiving approval. Third, USA should correlate negatively
with self-deception. USA is incompatible with self-deception because
the self-accepting individual is aware of his or her strengths and
weaknesses (Ellis, 1976) and is not invested in inflating the sense of
self-worth (Ellis, 1977). Fourth, USA should correlate negatively with
narcissism. According to REBT, narcissism stems from an insistence
on the approval of others in order to maintain ones self-worth (Ellis &
Tafrate, 1997). Avoiding evaluation of self-worth entirely, therefore,
should result in diminished grandiosity. Fifth, USA should correlate
positively with happiness and general well-being. Striving for enjoyment of life is a fundamental goal of REBT and of USA (Ellis & Harper, 1997) and an expected outcome of embracing the USA belief system. Finally, USA should correlate positively with mood subsequent to
negative events, relative to baseline mood. REBT does not suggest that
self-accepting people have no negative emotional reactions to negative
events but that these reactions are muted (e.g., mild disappointment
vs. severe despair) because the sense of self-worth is not threatened
(Ellis & Harper, 1997).
We also retested the six predictions just described, controlling statistically for self-esteem level, in order to evaluate the incremental utility
of USA relative to the better-established construct of self-esteem.

METHOD
Participants
Adult volunteers (N 107; 61 women and 46 men) were recruited
from a newspaper advertisement requesting participation in person-

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Journal of Rational-Emotive & Cognitive-Behavior Therapy

ality research. Ages ranged from 19 to 81, with a mean age of 48.9.
Participants were each paid ten dollars for their participation.
Measures
A novel measure of unconditional self-acceptance was created. The
Unconditional Self-Acceptance Questionnaire (USAQ) consisted of 20
statements intended to reflect the various aspects of USA philosophy
and practice as distilled from REBT literature on the subject (see Appendix). Participants responded to each on a scale ranging from 1 (Almost Always Untrue) to 7 (Almost Always True) depending on their
perceptions of how characteristic the statement was of them. Nine
items were worded such that higher scores represented greater USA
(e.g., I avoid comparing myself to others to decide if I am a worthwhile person), while 11 items were reverse-scored because they were
worded such that lower self-reported frequencies represented greater
USA (e.g., I set goals for myself that I hope will prove my worth).
Internal consistency of the USAQ was moderate (alpha .72), which
seems acceptable for a multifaceted construct such as self-acceptance.
Self-esteem was measured with the Rosenberg Self-Esteem scale
(RSE; Rosenberg, 1965). The RSE is a widely used 10-item 4-point
Likert-type scale with high internal consistency, 2-week retest reliability, and convergent and discriminant validity (Robinson &
Shaver, 1973).
Depressive symptoms were measured with the Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979), a 21-item, 4-point
Likert-type scale with demonstrated high internal consistency and
high convergent validity with interview ratings of depression severity
(Beck, Steer, & Garbin, 1988).
Anxiety symptoms were measured with the Beck Anxiety Inventory
(BAI; Beck, Epstein, Brown, & Steer, 1988). The BAI is a 21-item,
4-point Likert-type scale which has shown high internal consistency
and 1-week test-retest reliability as well as convergent and discriminant validity (Beck, Epstein et al., 1988).
Self-deception was measured with the Marlowe-Crowne scale, a 33item true-false inventory showing good internal consistency and
1-month retest reliability (Crowne & Marlowe, 1960). The MarloweCrowne was originally intended as a measure of social desirability.
However, research suggests that it measures a tendency toward selfdeception rather than an inclination to look good to others (Weinberger, 1990).

John M. Chamberlain and David A. F. Haaga

167

Narcissism was measured with the Narcissistic Personality Inventory (NPI; Raskin & Hall, 1979), a 29-item forced-choice measure designed to measure individual differences in narcissism in nonclinical
populations. The NPI has shown high internal consistency and alternate-form reliability (Raskin & Hall, 1981) and moderate convergence
with observer-ratings of narcissism (Raskin & Terry, 1988).
Happiness and general well-being were measured with the Satisfaction with Life Scale (Pavot & Diener, 1993), a 5-item, 7-point Likerttype scale which has been shown to have good internal consistency and
2-month test-retest reliability (Pavot & Diener, 1993), and by the Happiness Measures (Fordyce, 1988), which ask respondents for a 10-point
Likert-type rating of their usual happiness and unhappiness and a
breakdown of the percentage of time they feel happy, unhappy, and
neutral. Despite the latter tests brevity (two items, essentially), its
combination score has shown good retest reliability, ranging from 0.62
over 4 months to .81 for 1 month to .98 for 2 days (Fordyce, 1988).
Mood reactivity to setbacks was measured via the Articulated
Thoughts during Simulated Situations (ATSS) paradigm (Davison,
Robins, & Johnson, 1983; Davison, Vogel, & Coffman, 1997). In the
ATSS paradigm participants are asked to imagine themselves in a situation as it is described to them on audiotape. The tape is interrupted
periodically to allow the participants to think aloud. These verbalizations are typically themselves audiotaped and later subjected to content analysis. In this study, we used ATSS primarily as a mechanism
for creating imaginal stress. We attempted to code for self-accepting
thoughts evident in participants responses but found that the vast
majority of this material did not clearly suggest high vs. low self-acceptance, an issue we return to in the Discussion section.
In our use of the ATSS paradigm, three scenarios were depicted: a
scenario involving the demise of a relationship with a romantic partner (7 segments), a stressful job application process (6 segments), and
a positive job-seeking outcome (2 segments). The romantic breakup
scenario was a modified version of one used by Solomon, Haaga,
Brody, Kirk, and Friedman (1998), while the job-seeking scenario and
positive job outcome scenario were written for this study.
State mood was measured four times, after an ATSS instructions
tape was played and after each of the three scenario tapes. Mood was
measured on a visual analog scale requiring the participant to mark a
line indicating how he or she felt at this very moment (Cowdry, Gardner, OLeary, Leibenluft, & Rubinow, 1991). Our indicator of mood in
response to negative events was a sum of two change scores: (mood

John M. Chamberlain and David A. F. Haaga

175

Robinson, J. P., & Shaver, P. R. (1973). Measures of social psychological attitudes. Ann Arbor, MI: Institute for Social Research.
Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Boston: Houghton Mifflin.
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ:
Princeton University Press.
Schlenker, B. R., Soraci, S., & McCarthy, B. (1976). Self-esteem and group
performance as determinants of egocentric perceptions in cooperative
groups. Human Relations, 29, 11631176.
Shrauger, J. S., & Lund, A. K. (1975). Self-evaluation and reactions to evaluations from others. Journal of Personality, 43, 94108.
Solomon, A., Haaga, D. A. F., Brody, C., Kirk, L., & Friedman, D. G. (1998).
Priming irrational beliefs in recovered-depressed people. Journal of Abnormal Psychology, 107, 440449.
Tarlow, E. M., & Haaga, D. A. F. (1996). Negative self-concept: Specificity to
depressive symptoms and relation to positive and negative affectivity.
Journal of Research in Personality, 30, 120127.
Weinberger, D. A. (1990). The construct validity of the repressive coping style.
In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp. 337385). Chicago: University of Chicago Press.

APPENDIX A
UNCONDITIONAL SELF-ACCEPTANCE QUESTIONNAIRE
INSTRUCTIONS: Please indicate how often you feel each statement
below is true or untrue of you. For each item, write the appropriate
number (1 to 7) on the line to the left of the statement, using the
following key:

Almost
Always
Untrue

Usually
Untrue

More
Often
Untrue
Than
True

Equally
Often
True
And
Untrue

More
Often
True
Than
Untrue

Usually
True

Almost
Always
True

1. Being praised makes me feel more valuable as a person.

2. I feel worthwhile even if I am not successful in meeting certain goals that are important to me.
3. When I receive negative feedback, I take it as an opportunity
to improve my behavior or performance.

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Journal of Rational-Emotive & Cognitive-Behavior Therapy

4. I feel that some people have more value than others.

5. Making a big mistake may be disappointing, but it doesnt
change how I feel about myself overall.
6. Sometimes I find myself thinking about whether I am a good
or bad person.
7. To feel like a worthwhile person, I must be loved by the people who are important to me.
8. I set goals for myself with the hope that they will make me
happy (or happier).
9. I think that being good at many things makes someone a
good person overall.
10. My sense of self-worth depends a lot on how I compare with
other people.
11. I believe that I am worthwhile simply because I am a human
being.
12. When I receive negative feedback, I often find it hard to be
open to what the person is saying about me.
13. I set goals for myself that I hope will prove my worth.
14. Being bad at certain things makes me value myself less.
15. I think that people who are successful in what they do are
especially worthwhile people.
16. I feel that the best part about being praised is that it helps
me to know what my strengths are.
17. I feel I am a valuable person even when other people disapprove of me.
18. I avoid comparing myself to others to decide if I am a worthwhile person.
19. When I am criticized or when I fail at something, I feel worse
about myself as a person.
20. I dont think its a good idea to judge my worth as a person.

John M. Chamberlain and David A. F. Haaga

175

Robinson, J. P., & Shaver, P. R. (1973). Measures of social psychological attitudes. Ann Arbor, MI: Institute for Social Research.
Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Boston: Houghton Mifflin.
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ:
Princeton University Press.
Schlenker, B. R., Soraci, S., & McCarthy, B. (1976). Self-esteem and group
performance as determinants of egocentric perceptions in cooperative
groups. Human Relations, 29, 11631176.
Shrauger, J. S., & Lund, A. K. (1975). Self-evaluation and reactions to evaluations from others. Journal of Personality, 43, 94108.
Solomon, A., Haaga, D. A. F., Brody, C., Kirk, L., & Friedman, D. G. (1998).
Priming irrational beliefs in recovered-depressed people. Journal of Abnormal Psychology, 107, 440449.
Tarlow, E. M., & Haaga, D. A. F. (1996). Negative self-concept: Specificity to
depressive symptoms and relation to positive and negative affectivity.
Journal of Research in Personality, 30, 120127.
Weinberger, D. A. (1990). The construct validity of the repressive coping style.
In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp. 337385). Chicago: University of Chicago Press.

APPENDIX A
UNCONDITIONAL SELF-ACCEPTANCE QUESTIONNAIRE
INSTRUCTIONS: Please indicate how often you feel each statement
below is true or untrue of you. For each item, write the appropriate
number (1 to 7) on the line to the left of the statement, using the
following key:

Almost
Always
Untrue

Usually
Untrue

More
Often
Untrue
Than
True

Equally
Often
True
And
Untrue

More
Often
True
Than
Untrue

Usually
True

Almost
Always
True

1. Being praised makes me feel more valuable as a person.

2. I feel worthwhile even if I am not successful in meeting certain goals that are important to me.
3. When I receive negative feedback, I take it as an opportunity
to improve my behavior or performance.

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Journal of Rational-Emotive & Cognitive-Behavior Therapy

4. I feel that some people have more value than others.

5. Making a big mistake may be disappointing, but it doesnt
change how I feel about myself overall.
6. Sometimes I find myself thinking about whether I am a good
or bad person.
7. To feel like a worthwhile person, I must be loved by the people who are important to me.
8. I set goals for myself with the hope that they will make me
happy (or happier).
9. I think that being good at many things makes someone a
good person overall.
10. My sense of self-worth depends a lot on how I compare with
other people.
11. I believe that I am worthwhile simply because I am a human
being.
12. When I receive negative feedback, I often find it hard to be
open to what the person is saying about me.
13. I set goals for myself that I hope will prove my worth.
14. Being bad at certain things makes me value myself less.
15. I think that people who are successful in what they do are
especially worthwhile people.
16. I feel that the best part about being praised is that it helps
me to know what my strengths are.
17. I feel I am a valuable person even when other people disapprove of me.
18. I avoid comparing myself to others to decide if I am a worthwhile person.
19. When I am criticized or when I fail at something, I feel worse
about myself as a person.
20. I dont think its a good idea to judge my worth as a person.